The Influence of Mode and Patient-ventilator Interaction on Sleep Quality in the ICU
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Respiratory Failure
- Sponsor
- Lawson Health Research Institute
- Enrollment
- 13
- Locations
- 1
- Primary Endpoint
- Sleep quality
- Status
- Completed
- Last Updated
- 13 years ago
Overview
Brief Summary
Patients requiring mechanical ventilation in the ICU will undergo three consecutive nights of polysomnography to record sleep patterns while receiving three modes of mechanical ventilation; Proportional assist ventilation (PAV), Pressure support ventilation (PSV), Assist control ventilation (ACV), applied in random order. The purpose is to determine the effect of mode of mechanical ventilation on patient-ventilator asynchrony and sleep quality.
Investigators
Karen Bosma
Principal Investigator
Lawson Health Research Institute
Eligibility Criteria
Inclusion Criteria
- •Age 18-75
- •received mechanical ventilation \>72 hours
- •glasgow coma scale \>10
- •acute physiology score \<13
- •ready for partial ventilatory support: intact respiratory drive, PaO2/FiO2 ratio \>200 on positive end expiratory pressure (PEEP) less than or equal to 5 cmH2O, and PH of 7.35 to 7.45
- •sedation: analgesia at dose not higher than 0.01 mg/kg/hr morphine equivalent x 48 hours, sedation at dose not higher than 0.01 mg/kg/hr lorazepam equivalent x 72 hours.
- •anticipate ongoing need for partial ventilatory support for the following 72 hours
Exclusion Criteria
- •Successful completion of spontaneous breathing trial
- •Neurological injury, encephalopathy or abnormal EEG
- •History of central sleep apnea
- •General anaesthesia within 72 hours from study entry
- •Requiring haloperidol \>10 mg/24 hours
- •hemodynamically unstable
Outcomes
Primary Outcomes
Sleep quality
Time Frame: 3 nights
Sleep fragmentation (number of arousals and awakenings/hr sleep), sleep architecture (% time asleep spent in Stage 1, 2, 3/4 and REM sleep)
Secondary Outcomes
- Patient-ventilator asynchrony(3 nights)